Perceived Infant Well-Being and Self-Reported Distress in Neonatal Nurses

Abstract

Background Infants who are admitted to a neonatal intensive care unit (NICU) may experience significant symptom burden. Parents are often distressed by these symptoms, which can affect their long-term coping and distress. There is limited research examining nurse perceptions of infant well-being (symptoms, suffering, and quality of life [QOL]) and associations with nurse distress. Objective The objective of this descriptive study was to explore associations between nurse perceptions of infant well-being and self-reported distress. Methods Nurses caring for infants with potentially life-threatening/life-limiting conditions were recruited from a Level IV NICU in the Midwestern United States as a part of a study on infant symptom burden. Nurses reported their perceptions of infant well-being and their own distress on a 5-point Likert scale. Surveys were administered at the bedside weekly for up to 12 weeks, depending on length of stay. Infant suffering and QOL were examined in relation to nurse distress. A cross-classified multilevel model was used to account for dependence within nurse and within patient. Results A total of 593 surveys were collected from nurses. Using a cross-classified multilevel model with variables entered simultaneously, nurse perceptions of greater infant suffering and lower infant QOL were significantly associated with greater nurse distress. Discussion Preliminary evidence shows that greater perceived infant suffering and lower perceived infant QOL may be associated with greater levels of self-reported distress in NICU nurses. Further work is needed to better understand factors related to symptom management in the NICU and the potential role of caregiver distress and compassion fatigue in NICU nurses.

Attitudes About Extremely Preterm Birth Among Obstetric and Neonatal Health Care Professionals in England

“…Perceptions of adverse outcomes appeared to underpin this variation, with statements reflecting the perceived effect of intensive care upon infants and evidence of disability in infants more often prioritized at the extremes of the distribution grid over statements highlighting parental involvement in decision-making. This reflects previous literature identifying that, particularly for neonatal nurses and neonatologists, perceived infant suffering and poor quality of life are distressing when caring for critically ill infants . Studies have consistently highlighted, however, the tendency for obstetricians, midwives, neonatologists, pediatricians, and neonatal nurses to underestimate survival and overestimate severe disability in extremely preterm infants .…”

“…This reflects previous literature identifying that, particularly for neonatal nurses and neonatologists, perceived infant suffering and poor quality of life are distressing when caring for critically ill infants. 29 , 32 Studies have consistently highlighted, however, the tendency for obstetricians, midwives, neonatologists, pediatricians, and neonatal nurses to underestimate survival and overestimate severe disability in extremely preterm infants. 33 , 34 , 35 , 36 The unpredictable outcomes for these infants creates the potential for misalignment and miscommunication between professionals and between parents and professionals.…”

Patient-reported outcome measures in children, adolescents, and young adults with palliative care needs—a scoping review

“…The PROMs were administered in several ways, such as through paper-, interview-, tablet-, or computer-based methods at home or in the clinic through a webpage or by e-mail. Furthermore, the expected time needed to answer was mentioned in 13 reports, ranging from 45 s to 2 h [ 54 , 59 – 61 , 67 , 78 , 84 , 87 , 91 , 97 , 105 , 116 , 133 ].…”

Medical staff's sentiments on the establishment of quiet time in the NICU

“…They believe that the concept of quiet time can reduce the energy consumption of premature infants, protect their neurological development and improve their prognosis. The clinical staff have common sense of care for the special group of high‐risk neonates (Fortney et al, 2020 ). In this interview, we found that medical staff subconsciously want to protect premature infants, do not want them to receive too much stimulation and hope that they can get enough rest and grow up healthily.…”